Wiki ER & OBS coding

Mindy Davis

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Let me explain why I am posting this under Emergency Medicine. The ER has an OBS unit in the hospital on a different floor and has a different TAX ID than the ER but I do coding for both companies.



1. Pt is seen in the ER. Pt requires hospitalization and an order is written by ER MD at 22:00 on 8/1/13 for pt to be placed in observation status. Observation MD rounds on pt at 08:00 on 8/2/13 and completes an H&P and gives further orders. Pt improves with treatment and is discharged at 16:00 on 8/2/13.

Date of Hospitalization: 8/1/13 ?
When can OBS MD bill for services? 8/1/13 or 8/2/13? Meaning, does he put on his claim for a 99220 for 8/1/13 or 8/2/13.
If OBS MD saw pt on 8/2/13 and discharged on 8/2/13, is this a same day admit/discharge? Or since order was written on 8/1/13, is this a separate admission & discharge?

2. Pt is seen in the ER. Pt requires hospitalization and an order is written by ER MD at 09:00 on 8/1/13 for pt to be placed in observation status. Observation MD rounds on pt at 09:30 on 8/1/13 and completes an H&P and gives further orders. Pt improves with treatment and is discharged at 16:00 on 8/1/13.

Can we bill for ER E/M and the OBS MD bill an observation E/M since this was an adm/discharge within 8 hours?
 
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